Gene expression analyses determine two different subpopulations in KIT-negative GIST-like (KNGL) patients.

INTRODUCTION: There are limited findings available on KIT-negative GIST-like (KNGL) population. Also, KIT expression may be post-transcriptionally regulated by miRNA221 and miRNA222. Hence, the aim of this study is to characterize KNGL population, by differential gene expression, and to analyze miRNA221/222 expression and their prognostic value in KNGL patients. METHODS: KIT, PDGFRA, DOG1, IGF1R, MIR221 and MIR222 expression levels were determined by qRT-PCR. We also analyzed KIT and PDGFRA mutations, DOG1 expression, by immunohistochemistry, along with clinical and pathological data. Disease-free survival (DFS) and overall survival (OS) differences were calculated using Log-rank test. RESULTS: Hierarchical cluster analyses from gene expression data identified two groups: group I had KIT, DOG1 and PDGFRA overexpression and IGF1R underexpression and group II had overexpression of IGF1R and low expression of KIT, DOG1 and PDGFRA. Group II had a significant worse OS (p = 0.013) in all the series, and showed a tendency for worse OS (p = 0.11), when analyzed only the localized cases. MiRNA222 expression was significantly lower in a control subset of KIT-positive GIST (p < 0.001). OS was significantly worse in KNGL cases with higher expression of MIR221 (p = 0.028) or MIR222 (p = 0.014). CONCLUSIONS: We identified two distinct KNGL subsets, with a different prognostic value. Increased levels of miRNA221/222, which are associated with worse OS, could explain the absence of KIT protein expression of most KNGL tumors.

Resultados clínico-oncológicos de la respuesta patológica completa en el cáncer de recto después de tratamiento neoadyuvante / Clinical and oncological results of the pathological complete response in rectal cancer after neoadjuvant treatment

Introduction Neoadjuvant chemo-radiotherapy is the treatment of choice for rectal cancer in order to reduce local recurrence. Patients with a pathological complete response (PCR) have a better prognosis. The aim of this study was to determine the influence of PCR on the oncological outcomes in our patients. Methods All patients with stage ii/iii rectal cancer treated with neoadjuvant chemo-radiotherapy and radical resection between 2007 and 2011were identified from a prospective database, and grouped based on whether they achieved PCR or not (non-PCR). Clinical, histological and oncological outcome data were compared. Results A total of 162 patients were included (62% men), with a mean age of 65 years. In terms of pre-operative TNM staging, 82 patients (50%) were T2, 75 (46%) were T3, and 5 (3%) were T4. Forty-two patients (25%) were N1, and 87 (53%) were N2. Low anterior resection and abdominoperineal resection were performed in 125 (77%) and 25 (15%) patients. Forty-three patients (26.5%) had postoperative morbidity. PCR was achieved in 19 patients (11.7%). After a median follow-up of 26 months, there are no recurrences in the PCR group, and in the non-PCR group, local recurrence was 1.4% (P = .78), and distant metastasis was 8.4% (P = .21). Overall survival (P = .39) and survival free of diseases (P = .23) were better in the PCR group, but the differences were not significant. Conclusion Patients with pathological complete response have better oncological outcome (AU)

Introducción La radioquimioterapia es el tratamiento de elección en el cáncer de recto para conseguir el control de la enfermedad. Los pacientes con respuesta patológica completa (RPC) presentan mejor pronóstico. El objetivo del trabajo es conocer nuestra incidencia de RPC y analizar los resultados oncológicos. Métodos Pacientes con neoplasia de recto estadios ii/iii , recogidos prospectivamente en el periodo comprendido entre 2007 y 2011. Los pacientes son sometidos a neoadyuvancia y a cirugía radical. Se dividen en 22 grupos según tengan o no RPC y se comparan las variables demográficas, clínicas e histológicas y su relación con la evolución oncológica. Resultados Se analizan 162 pacientes (62% varones) con una edad media de 65 a. La incidencia de RPC es del 11,7% (19 pacientes). El 50% de los pacientes son T2, el 46% son T3 y el 3% son T4, mientras que el 25% son N1 y el 53% son N2 antes de la neoadyuvancia. En 25 pacientes (15%)se ha practicado una amputación de recto y en 125 (77%) una resección anterior baja. La morbilidad global es del 26,5%(43 pacientes). Con una mediana de seguimiento de 26 meses, ningún paciente con RPC ha presentado recurrencia tumoral. En el grupo de NO-RPC la recidiva local es del 1,4% (p = 0,78) y las metástasis del 8,4% (p = 0,21), siendo la supervivencia global y la libre de enfermedad mayor en el grupo con RPC pero sin diferencias significativas (p = 0,39, p = 0,23). Conclusión La presencia de RPC después de tratamiento neoadyuvante se relaciona con mejores resultados oncológicos (AU)

[Clinical and oncological results of the pathological complete response in rectal cancer after neoadjuvant treatment]. / Resultados clínico-oncológicos de la respuesta patológica completa en el cáncer de recto después de tratamiento neoadyuvante.

INTRODUCTION: Neoadjuvant chemo-radiotherapy is the treatment of choice for rectal cancer in order to reduce local recurrence. Patients with a pathological complete response (PCR) have a better prognosis. The aim of this study was to determine the influence of PCR on the oncological outcomes in our patients. METHODS: All patients with stage ii/iii rectal cancer treated with neoadjuvant chemo-radiotherapy and radical resection between 2007 and 2011 were identified from a prospective database, and grouped based on whether they achieved PCR or not (non-PCR). Clinical, histological and oncological outcome data were compared. RESULTS: A total of 162 patients were included (62% men), with a mean age of 65 years. In terms of pre-operative TNM staging, 82 patients (50%) were T2, 75 (46%) were T3, and 5 (3%) were T4. Forty-two patients (25%) were N1, and 87 (53%) were N2. Low anterior resection and abdominoperineal resection were performed in 125 (77%) and 25 (15%) patients. Forty-three patients (26.5%) had postoperative morbidity. PCR was achieved in 19 patients (11.7%). After a median follow-up of 26 months, there are no recurrences in the PCR group, and in the non-PCR group, local recurrence was 1.4% (P=.78), and distant metastasis was 8.4% (P=.21). Overall survival (P=.39) and survival free of diseases (P=.23) were better in the PCR group, but the differences were not significant. CONCLUSION: Patients with pathological complete response have better oncological outcome.